Slums or Salvation?

Some people call them “necessary evils,” while others call them “rat
traps.” In any case, unlicensed boarding homes for the mentally
ill—which, since they are simply boarding houses, don’t require
governmental licensing—are beginning to draw attention.

The number of unlicensed boarding homes in Tucson is estimated to
exceed 50, based on information from several sources.

According to data from the Arizona Department of Health Services,
there are 26 somewhat similar, but licensed residential facilities in
town. These homes, which typically house a dozen people or less,
provide extra care and are therefore subject to both stringent city and
state regulations.

Carter, not his real name, has lived in boarding homes his entire
adult life. He estimates he’s been in 15 of them over the past three
decades.

“The homes I lived in were (mostly) slums,” Carter remembers. “Some
are run properly, but some are shipwrecks.”

He says he receives approximately $600 per month from Social
Security, and $500 goes toward room and board. Despite his lack of
cash, Carter complains that staff members at many boarding homes have
badgered him for money, cigarettes and sodas.

He also refers to the meals that are served—like rice and
beans, soups and peanut-butter-and-jelly sandwiches, with water to
drink—as “slop.”

Neal Cash leads the Community Partnership of Southern Arizona (CPSA),
an agency responsible for “the coordination of publicly funded
behavioral health treatment and prevention services.”

CPSA contracts with three provider organizations—CODAC, COPE
and La Frontera. Each of these agencies has their own licensed
residential facilities and also has clients living at the privately
operated boarding homes.

“If we hear complaints,” Cash says of the unlicensed facilities, “we
put the word out to the providers.” He adds that these facilities can’t
all be painted with the same broad brush, because there are indeed some
good ones.

“I’ve always supported certification and licensing of these
facilities,” Cash adds, “but the flipside … is that will drive costs
up, and some of them will go out of business.”

CPSA works with the Pima County Human Rights Committee on issues
concerning the mentally ill. Susan Hyder is vice-chair of the group and
indicates they have a subcommittee making site visits to unlicensed
boarding homes.

“They’ll make a report,” Hyder says of the subcommittee, “and
depending on the situation, the information will be passed on to
appropriate parties. The full committee will then follow up.”

Calling boarding homes an issue of “great concern,” Hyder says the
unlicensed facilities range in quality—with some of them being
“out-and-out money-grabbing operations.”

“This population,” Hyder observes of the mentally ill, “are often
extremely vulnerable to being taken advantage of.”

Francine likes the boarding home she currently occupies—after
being in three where she wasn’t comfortable.

“The house managers didn’t enforce boundary rules,” she says about
privacy at the earlier establishments. But at her current location, she
says everyone gets along.

“I want to stay there,” Francine says.

Clarke Romans is executive director of the National Alliance on
Mental Illness of Southern Arizona (NAMISA).

“Most of the complaints we get are about unlicensed homes,” he says,
estimating that NAMISA gets about 25 complaints a year. He calls some
of the facilities “junkyards.”

Romans acknowledges that many concerns are raised only after a
person has left a particular facility. Plus, he adds: “The providers
(like CODAC, COPE and La Frontera) don’t check the way they
should”—an allegation they deny.

Despite this criticism, Romans understands why the providers have
problems.

“Fundamentally,” he says, “most problems arise, because case
managers have way too many (80 to 100) clients. Each client gets less
than one hour of attention per month, so there’s no way they can go see
where people live.”

Dan Ranieri, CEO of La Frontera, thinks more affordable housing for
the mentally ill is vital. He indicates that because of regulations,
the apartments his agency operates can only charge a person one-third
of their income. “The boarding home has no such restriction,” he
says.

Ranieri says La Frontera has clients in about 30 boarding homes and
calls them “a mixed bag.” He believes finding jobs for those living in
these homes is a key. “That’s a big focus of ours,” he says.

The head of CODAC, Mark Clark, agrees. As for the current situation,
he observes: “People are forced by the market to live in a place where
the quality is not what you’d wish it to be.”

For his part, Tom Donovan, the interim CEO of COPE, says his agency
now has 57 clients living in boarding homes.

“They’re a necessary evil,” Donovan says, “but our strong preference
is to put people into independent-living situations.”

For two years, Janet has been in a facility operated by one of the
providers, and she enjoys it immensely. Previously, she lived in a
series of boarding homes, and says, “I never want to go back
there.”

“It was a nightmare,” Janet says about her last boarding-home
experience. “There wasn’t enough food or privacy. There was only one
meal a day, so people were starving. Plus, they didn’t have toilet
paper for weeks.”

Janet also says she was afraid of the other tenants. “They looked
like they were severely mentally ill, and they would fight and
argue.”

From his perspective, Clarke Romans sees the lack of housing options
as a major problem.

“If the rat traps are required to have licenses, they’d go out of
business. Then the folks (who live in them) would have no place to
turn,” he says.

Susan Hyder says that boarding homes need to be licensed.

“A secure, safe and supportive environment is critical,” she
says.

This article appears in Aug 13-19, 2009.